Pre-hospital cardiopulmonary resuscitation supported by ECMO – a case series of 6 patients

Extracorporeal cardiopulmonary resuscitation in adults and children: A review of literature, published guidelines and pediatric single-center program building experience

“…Favorable predictors include age ( 43 , 68 , 99 ), IHCA ( 48 , 51 , 67 , 100 , 101 ), shockable rhythm ( 28 , 55 , 68 , 78 , 84 , 97 – 99 , 102 , 103 ), temporary ROSC ( 68 , 84 , 104 ), witnessed arrest with bystander CPR ( 104 ), shorter CCPR duration or time from arrest to ECMO ( 28 , 43 , 51 , 64 , 67 , 68 , 83 , 86 , 87 , 94 , 96 , 102 – 104 ), higher baseline pH ( 93 , 98 , 99 , 102 , 103 ), lower baseline lactate ( 51 , 86 , 98 , 102 , 103 ) and percutaneous coronary intervention ( 43 , 48 , 91 , 102 ). Pre-hospital cannulation for OHCA ECPR may have additional benefits on survival and neurologic outcome by reducing low-flow time for patients with longer anticipated transport times ( 83 , 84 , 91 , 95 , 105 ).…”

ECMO as an emergency medical countermeasure

“…Some French, German, and Taiwanese centres have reported the feasibility of use of ECMO for cardiopulmonary arrest by trained interdisciplinary teams. 5,6,7 The French fi eld ECMO programme was established to specifi cally deal with the anticipated need for mobile ECMO in an H1N1 epidemic. 5 This programme enhanced the possibility of incorporating ECMO into comprehensive emergency preparedness programmes as a medical Michael Donne/Science Photo Library countermeasure against epidemics or terrorist actions that could lead to ARDS.…”

“…5 Respiratory medicine has the lowest success rate of any therapeutic area in bringing new drugs to market, with 3% of drugs entering clinical trials gaining approval. 6 An overly complex regulatory environment and exaggerated concerns about safety have been powerful disincentives for people who might have otherwise become involved in drug research.…”